PM 08-02-07-b: Effect of SSI Lump Sum (Medical)

Where a Medical client is living when they receive an SSI lump sum payment affects how the payment will be treated.

For a Medical client who lives in the community, the SSI lump sum payment is exempt as income and as an asset in the month of receipt. The SSI lump sum monies remain exempt if they are kept separately identifiable from nonexempt monies.

For a Medical client who lives in a medical facility (including a long term care facility), or a supportive living facility, an SSI lump sum payment, except for a lump sum paid into a dedicated account, is available income for the month of receipt.
Any amount remaining after the month of receipt is a nonexempt asset subject to the asset limit.

NOTE: An SSI lump sum payment paid for a child under age 18 that is directly deposited into a dedicated bank account, is exempt. The lump sum payment is exempt as income in the month received. Any amount remaining after
the month or receipt is exempt.

If a Medical client who has received an SSI lump sum enters a medical facility (including a long term care facility), or a supportive living facility, determine if the stay will be long term or temporary (3 months or less). If the stay is long term,
the SSI lump sum becomes nonexempt and subject to the asset limit. If all other factors of eligibility are met, enroll the client in spenddown.

If the stay is expected to be temporary, the SSI lump sum remains exempt. If the client is still in the facility at the end of 3 months, determine if the client will be returning home or remaining in the facility. If the client's doctor states that
the client will be returning home, the Family Community Resource Center administrator can approve a 3-month extension of the money's exempt status. The maximum SSI exemption period is 6 months.

If the client remains in the facility after the 2nd 3-month period ends, the remaining money become a nonexempt asset. If nonexempt assets exceed the asset limit, and all other factors of eligibility are met, enroll the client in spenddown.